Individual provider Active NPI

Theresa Dolan, APN

  • Family Nurse Practitioner
  • Downers Grove, IL
National Provider Identifier
1003294620
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.012794 Issued in IL
Practice address
1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624
Phone
(630) 829-1038
Fax
(630) 829-1080
NPI assigned
May 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.012794 IL Primary

Addresses

Primary practice location

1441 Branding Ave Ste 310
Downers Grove, IL 60515-5624

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other names 1

  • Theresa Nugent Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tdolan205290@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702001928 IL Practitioner - Nurse Practitioner 1557673605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1441 Branding Ave
Suite 200
Downers Grove, IL 60515-5624
Phone (630) 829-1084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.012794ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Feb 26, 2018 Accepting new patients
Sandeep Chandra MD SC CurrentSince May 26, 2015 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Feb 26, 2018 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

5331 W 79th St
Burbank, IL 60459
Phone (704) 422-9577

29373 Network Pl
Chicago, IL 60673

1441 Branding Ave
Ste 310
Downers Grove, IL 60515
Phone (630) 829-1038

1441 Branding Ave
Ste 200
Downers Grove, IL 60515
Phone (630) 829-1084

Interoperability endpoints

  • Direct secure messaging: tdolan205290@direct.myadvocateaurora.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1003294620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 BRANDING AVE STE 310",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155624",
            "telephone_number": "630-829-1038",
            "fax_number": "630-829-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "THERESA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdolan205290@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1441 Branding Ave Ste 310",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605155624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "NUGENT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.